Emergence of carbapenem resistant gram-negative pathogens with high rate of colistin resistance in Egypt: A cross sectional study to assess resistance trends during the COVID-19 pandemic

IF 3.5 Q3 Biochemistry, Genetics and Molecular Biology Journal of Genetic Engineering and Biotechnology Pub Date : 2024-01-23 DOI:10.1016/j.jgeb.2024.100351
Fatma A. Afify , Ahmed H. Shata , Nirmeen Aboelnaga , Dina Osama , Salma W. Elsayed , Nehal A. Saif , Shaimaa F. Mouftah , Sherine M. Shawky , Ahmed A. Mohamed , Omar Loay , Mohamed Elhadidy
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Abstract

The current study investigated the temporal phenotypic and genotypic antimicrobial resistance (AMR) trends among multi-drug resistant and carbapenem-resistant Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa recovered from Egyptian clinical settings between 2020 and 2021. Bacterial identification and antimicrobial sensitivity of 111 clinical isolates against a panel of antibiotics were performed. Molecular screening for antibiotic resistance determinants along with integrons and associated gene cassettes was implemented. An alarming rate (98.2%) of these isolates were found to be phenotypically resistant to carbapenem. Although 23.9 % K. pneumoniae isolates were phenotypically resistant to colistin, no mobile colistin resistance (mcr) genes were detected. Among carbapenem-resistant isolates, blaNDM and blaOXA-48-like were the most prevalent genetic determinants and were significantly overrepresented among K. pneumoniae. Furthermore, 84.78% of K. pneumoniae isolates co-produced these two carbapenemase genes. The plasmid-mediated quinolone resistance genes (qnrS and qnrB) were detected among the bacterial species and were significantly more prevalent among K. pneumoniae. Moreover, Class 1 integron was detected in 82% of the bacterial isolates. This study alarmingly reveals elevated resistance to last-resort antibiotics such as carbapenems as well as colistin which impose a considerable burden in the health care settings in Egypt. Our future work will implement high throughput sequencing-based antimicrobial resistance surveillance analysis for characterization of novel AMR determinants. This information could be applied as a step forward to establish a robust antibiotic stewardship program in Egyptian clinical settings, thereby addressing the rising challenges of AMR.

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埃及出现耐碳青霉烯类革兰氏阴性病原体,对可乐定耐药率高:评估 COVID-19 大流行期间耐药性趋势的横断面研究
本研究调查了 2020 年至 2021 年期间从埃及临床环境中回收的耐多药和耐碳青霉烯类抗菌药物(AMR)的表型和基因型趋势。对 111 例临床分离菌进行了细菌鉴定并确定了其对一系列抗生素的抗菌敏感性。对抗生素耐药性决定因子以及整合子和相关基因盒进行了分子筛选。结果发现,这些分离菌株中有98.2%对碳青霉烯类具有表型耐药性。虽然 23.9% 的肺炎克雷伯菌分离株对可乐定具有表型耐药性,但未检测到移动可乐定耐药性(mcr)基因。在耐碳青霉烯类的分离株中,blaNDM 和 blaOXA-48-like 是最普遍的基因决定因子,在肺炎克雷伯菌中的比例明显偏高。此外,84.78%的肺炎克雷伯菌分离株同时产生这两种碳青霉烯酶基因。质粒介导的喹诺酮类药物耐药基因(qnrS 和 qnrB)在细菌种类中均有检出,且在肺炎克雷伯菌中明显较多。此外,在 82% 的细菌分离物中检测到了 1 类整合子。这项研究令人震惊地揭示了对碳青霉烯类和可乐定等最后一种抗生素的耐药性升高,这给埃及的医疗机构造成了相当大的负担。我们今后的工作将以高通量测序为基础进行抗菌药耐药性监测分析,以确定新型 AMR 决定因素的特征。这些信息可用于在埃及临床环境中建立健全的抗生素管理计划,从而应对日益严峻的 AMR 挑战。
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来源期刊
Journal of Genetic Engineering and Biotechnology
Journal of Genetic Engineering and Biotechnology Biochemistry, Genetics and Molecular Biology-Biotechnology
CiteScore
5.70
自引率
5.70%
发文量
159
审稿时长
16 weeks
期刊介绍: Journal of genetic engineering and biotechnology is devoted to rapid publication of full-length research papers that leads to significant contribution in advancing knowledge in genetic engineering and biotechnology and provide novel perspectives in this research area. JGEB includes all major themes related to genetic engineering and recombinant DNA. The area of interest of JGEB includes but not restricted to: •Plant genetics •Animal genetics •Bacterial enzymes •Agricultural Biotechnology, •Biochemistry, •Biophysics, •Bioinformatics, •Environmental Biotechnology, •Industrial Biotechnology, •Microbial biotechnology, •Medical Biotechnology, •Bioenergy, Biosafety, •Biosecurity, •Bioethics, •GMOS, •Genomic, •Proteomic JGEB accepts
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